By Dr. Aruna Muralidhar,
Associate Director and Senior Obstetrician and Gynaecologist, Fortis La Femme, Bangalore
Make a choice but choose wisely
Personal choices have to be a woman’s prerogative especially when it comes to her fertility and family planning. It is not uncommon for me to see women who wish to postpone their pregnancy to late thirties, sometimes even early forties. I also see women who request for termination of pregnancy on the basis of social reasons such as interference to career progression, premarital or extramarital relationships, failure of contraception or just an unexpected pregnancy which resulted in the heat of the moment.
The important aspect about offering a termination is to make sure it is absolutely desired and there is no dilemma about the decision. Any hesitation or guilt has to be addressed completely by the couple as well as by the doctor. Also, a safe procedure has to be performed depending on the background history of any past pregnancies, any procedures or surgeries undergone in the past as well as the general health of the woman. Hence, a proper consultation would be vital. Any sort of online consultation or taking medications over the counter from a pharmacist can lead to unwanted complications which are sometimes serious.
Pregnancy termination can be safely performed either by medical or surgical procedure. The options are generally given to the lady along with the procedure being explained in detail along with counselling regarding possible risks including rare ones. Once the decision is made, it is important to undergo certain blood tests and an ultrasound scan. The blood work will identify any concerns such as low haemoglobin which requires a close vigil on blood loss, a negative blood group which may require an additional injection, or even a lurking thyroid problem which may need to be treated. The ultrasound scan is essential for determining the stage and location of the pregnancy. The standard procedure will only work in pregnancies within the womb. Rarely, the pregnancy can be outside the womb (commonly in the fallopian tube), for which a different approach is required urgently.
The procedure if done medically is generally a 2-step procedure requiring 2 different types of medications 1-2 days apart. Supervision in the hospital is advised in most cases to ascertain completion of the procedure and to watch for symptoms of pain, nausea, vomiting or giddiness etc. It is important to get a review check and a scan after a week to ascertain the womb is completely empty.
Surgical method is sometimes chosen in certain situations for its quickness, completeness and also painlessness as it is done under anaesthesia and usually under ultrasound guidance. However, there are uncommon and rare risks of injury to the womb and the neck of the womb.
It is very important for the procedure to be done under antibiotic cover to prevent unwanted infections. The government regulations have to abided by provided the duly filled forms (which are anonymous) after the termination procedure.
All in all, terminations are now-a-days common procedures but have to be done safely to avoid unnecessary and sometimes serious complications. But over and above this, prevention of unwanted pregnancy with effective contraception is of paramount importance. Wishing you all a safe reproductive life!